Dual-center Clinical Data Characteristics And Risk Factors Of Myocardial Infarction With Non-obstructive Coronary Arteries

Background:Significant coronary stenosis or occlusion were seen in coronary arteries in 90% of patients with Acute Myocardial Infarction(AMI)when operated with Coronary Angiography(CAG),while 10% of patients with negative or mild stenosis,defined with Myocardial Infarction with Non-obstructive Coronary Arteries(MINOCA).This study aimed to explore the clinical features and potential risk factors associated with MINOCA by analyzing the clinical data of patients with coronary non-obstructive and obstructive myocardial infarction.Methods:We enrolled patients diagnosed of AMI in Department of Cardiology of the Affiliated Hospital of You Jiang Medical University for Nationalities and our hospital from September 2012 to September 2018.A total of 40 cases(30 males and 10 females)diagnosed with MINOCA(no stenosis or coronary stenosis <50%)by CAG were enrolled,and 120 AMI patients confirmed by CAG(severe coronary stenosis or complete occlusion)were randomly selected as control group(104 males and 16females).The clinical data of the two groups were analyzed by univariate analysis and unconditional logistic regression analysis for statistically index,and found out their clinical value.Results:1.By comparing the baseline data between the two groups,we have found several significant differences between two of them,including age,total cholesterol(TC),Cystatin-C,e-GFR,low density lipoprotein C(LDL-C),left ventricular ejection fraction(LVEF),drinking history,hypertension and myocardial bridge;2.We used unconditional logisitic analysis to analyze these factors and the results indicated that there were statistically significances in the following indexes,including age(OR 0.95,95%CI: 0.918-0.984,P?0.05),LDL-C(OR 0.558,95%CI:0.339-0.918,P ? 0.05),myocardial bridge(OR 8.073,95%CI:1.62-40.239,P ? 0.05),drinking history(OR 2.887,95%CI:1.089-7.656,P?0.05).Age and low-density lipoprotein Cwere negatively correlated with the incidence of MINOCA.The history of coronary artery bridge and drinking was positively correlated with the incidence of MINOCA.3.TIMI blood flow in patients with MINOCA was better than that in patients with obstructive AMI.There was a statistically significant difference between the groups(Z=6.705,P=0.000).4.There were no significant differences in baseline data and TIMI blood flow grading between STEMI and NSTEMI patients in the overall and obstructive AMI groups(TIMI blood flow: overall patients(Z=0.044,P=0.965);obstructive AMI group(Z= 0.058,P=0.954)).Conclusion:1.Compared with patients with obstructive AMI,MINOCA patients are characterized by young(age: 48.43 ± 13.60)and low LDL-C levels(2.49 ± 0.95 mmol/L);2.Myocardial bridge and drinking history increase the risk of MINOCA;3.TIMI blood flow in patients with MINOCA is superior to patients with obstructive AMI;...